Low on-treatment diastolic blood pressure and cardiovascular outcome: A post-hoc analysis using NHLBI SPRINT Research Materials.

Pubmed ID: 31506550

Pubmed Central ID: PMC6737094

Journal: Scientific reports

Publication Date: Sept. 10, 2019

Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6737094/pdf/41598_2019_Article_49557.pdf?link_time=2024-12-22_18:48:16.455982

MeSH Terms: Humans, Male, Female, Aged, Aged, 80 and over, Cardiovascular Diseases, Risk Factors, Middle Aged, ROC Curve, Proportional Hazards Models, Blood Pressure, Prognosis, Kaplan-Meier Estimate, Cardiovascular System, Biomarkers

Authors: Sobieraj P, Lewandowski J, Siński M, Gaciong Z

Cite As: Sobieraj P, Lewandowski J, Siński M, Gaciong Z. Low on-treatment diastolic blood pressure and cardiovascular outcome: A post-hoc analysis using NHLBI SPRINT Research Materials. Sci Rep 2019 Sep 10;9(1):13070.

Studies:

Systolic Blood Pressure Intervention Trial (SPRINT)
Systolic Blood Pressure Intervention Trial Primary Outcome Paper (SPRINT-POP) Data

Abstract

Recent studies including the SPRINT trial have shown beneficial effects of intensive systolic blood pressure reduction over the standard approach. The awareness of the J-curve for diastolic blood pressure (DBP) causes some uncertainty regarding the net clinical effects of blood pressure reduction. The current analysis was performed to investigate effects of low on-treatment DBP on cardiovascular risk in the SPRINT population. The primary composite outcome was the occurrence of myocardial infarction, acute coronary syndrome not resulting in myocardial infarction, stroke, acute decompensated heart failure or death from cardiovascular causes. The prevalence of primary outcomes was significantly higher in subjects within low DBP in both standard (44-67 mmHg [10.8%] vs 67-73 mmHg [6.7%] vs 73-78 mmHg [5.1%] vs 78-83 mmHg [4.4%] vs 83-113 mmHg [4.3%], p < 0.001) and intensive treatment (38-61 mmHg [6.7%] vs 61-66 mmHg [4.1%] vs 66-70 mmHg [4.5%] vs 70-74 mmHg [2.7%] vs 74-113 mmHg [3.4%], p < 0.001) arms. After adjusting for covariates, low DBP showed no significant effects on cardiovascular risk. Therefore, while reaching blood pressure targets, low DBP should not be a matter of concern.